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The role of PPAR\u03b1 and PPAR\u03b3 in cardiac ischaemia\u2010reperfusion injury, infarct healing and hypertrophy is the subject of intense research. Due to the later development of PPAR\u03b4\u2010specific ligands, the role of this PPAR isoform in cardiac disease remains to be established. Although many studies point to salutatory effects of PPAR ligands in cardiac disease, the exact molecular mechanism is still largely unsolved. Both the metabolic (via transactivation) and the more recently discovered anti\u2010inflammatory (via transrepression) effects of PPARs are likely to play a role. In this review the reported, and sometimes contradictory, effects of PPAR ligands on ischaemia\u2010reperfusion, infarct healing and cardiac hypertrophy are critically evaluated. In particular the role of inflammation in these disease processes, the ability of PPARs to interfere with pro\u2010inflammatory processes, and the mechanisms of transrepression are discussed. 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